The present invention relates generally to fluid infusion and more particularly, to identifying a patient and medication so that correct medication is infused into a patient.
Physicians and other medical personnel apply intravenous (“IV”) infusion therapy to treat various medical complications in patients. IV infusion therapy typically involves infusing medical fluids, such as drugs or nutrients, from a fluid supply, such as a bag, bottle, or other container, through the tube of a fluid administration set to a cannula inserted into a patient's blood vessel. In a typical facility, a physician enters an order for medication for a particular patient. This order may be handled either as a simple prescription slip, or it may be entered into an automated system, such as a physician order entry (“POE”) system. The prescription slip or the electronic prescription from the POE system is routed to the pharmacy, where the order is checked, then filled. Typically, pharmacies check the physician order against possible allergies of the patient and for possible medication interactions in the case where two or more medications are prescribed, and also check for contra-indications. For a medication that is to be delivered by IV, the prescribed medication is prepared by a pharmacist and added to a bag or bottle or other suitable container at the pharmacy. A pharmacist also typically identifies the prepared order, identifies the contents of the bag or bottle, and identifies the patient for whom the bag or bottle is intended with a paper label that is attached to the bag or bottle and in some cases by other means, such as, for example, including a bar code or magnetic device, or by use of a radio frequency (RF) signal interactive device such as an RFID tag. In the case of non-IV drugs, such as oral medications, the drug may itself be labeled with the order or drug information (including the patient identifier) or may be inserted into a container that is labeled. Depending on the facility, the medication may be placed into a transport carrier for transport to a nurse station. Once at the nurse station, the prescriptions are once again checked against the medications that have been identified for delivery to ensure that no errors have occurred. If all is in order, the medication is subsequently administered to the patient.
Medication errors, that is, errors that occur in the ordering, dispensing, and administration of medications, regardless of whether those errors caused injury or not, are a significant consideration in the delivery of healthcare in the institutional setting. Additionally, adverse drug events (“ADE”), defined as injuries involving a drug that require medical intervention and representing some of the most serious medication errors, are responsible for a number of patient injuries and death. Healthcare facilities continually search for ways to reduce the occurrence of medication errors. Various systems and methods are being developed at present to reduce the frequency of occurrence and severity of preventable adverse drug events (“PADE”) and other drug errors. In the administration of drugs, focus is typically directed to the following five “rights” or factors; that is, the right drug is directed to the right patient, in the right amount, through the right route, and at the right time. Systems and methods seeking to reduce ADE's and PADE's should take these five rights into consideration.
For safety reasons and in order to achieve optimal results, the medication is often administered in accurate amounts as prescribed by the doctor and in a controlled fashion by using an infusion pump. Infusion pumps operate by displacing the fluid in a fluid administration set to force fluid from the fluid supply through the tube and into the patient. The infusion pump is programmed by a clinician, such as a nurse, with operating parameters to achieve the administration of the medication as prescribed by the physician. Such operating, or pumping, parameters are medication- and patient-specific. That is, the pumping parameters are selected based on the particular medication prescribed and the specific patient for whom they are intended. It is the nurse's responsibility to match the prescribed medication with the correct patient and with the properly programmed pump.
Medical infusion pumps have advanced greatly over the years and permit more precise infusion control resulting in much better treatment for patients. Doctors are more assured that the doses and infusion rates that they prescribe for their patients can be delivered to the patients accurately by infusion pumps to achieve optimum therapeutic effect. However, there remains a continuing concern that the right medication is matched to the right pump and to the right patient.
Prior attempts have been made to assure that the right medication is administered to the right patient through the right pump. In one example, a bar code label identifying the medication and patient is applied to the bag containing the medication at the pharmacy. After a clinician manually programs the pump, a bar code scanner connected to the pump is used to read the bar code label on the bag of medication to verify that it identifies the same medication as that programmed into the pump. In another example, a bar code label applied to the bag of medication is read with a bar code scanner built into the housing of the pump to automatically program the pump, thus avoiding manual programming entirely. However, prior art systems do not link a scanned medication or drug to a drug library entry and therefore do not give the combined protection of dose limits and right drug, right patient. However, the Medley medication safety system from ALARIS Products of Cardinal Health, San Diego, Calif., U.S.A., provides this level of protection in networked and non-networked environments.
These advanced infusion pumps have revolutionized the way intravenous (“IV”) medications are delivered by providing dose limit protection, thus ensuring that the right dose of the medication is delivered to the patient. Still missing from these pumps is the ability to automatically select the right medication from the pump's drug library, ensure that the medication being administered is for the patient that is currently connected to the pump, and that the clinician administering the medication is authorized to do so.
As the name implies, multi-channel infusion pumps have more than one pumping channel, and a respective infusion line or administration set can be installed into each channel. This arrangement allows the pump of each channel to be programmed to deliver the particular medication that flows through the respective infusion line or set installed in the channel such that each line may deliver a different medication at different rates or in different volumes. In cases where a single patient may be prescribed multiple simultaneous infusions for different medications, sometimes four or more, the multi-channel infusion pump provides a distinct advantage. Each channel of a single pump may be programmed differently. Such multi-channel infusion pumps may be modular, in which case the number of channels may be varied, or may be fixed, such as a dual-channel pump. In most cases, all channels of a multi-channel infusion pump are under the control of a common controller or processor. Alternatively, multiple single-channel pumps may be used to simultaneously infuse multiple medications into a patient. One potential problem that exists when infusing a patient with multiple infusion medications, whether through a multi-channel pump or through multiple single-channel pumps, is ensuring that each infusion channel or pump is properly programmed to deliver its respective medication. That is, the particular pump or channel of a pump is properly programmed to deliver the particular medication of the container to which the fluid line of that channel or pump is connected.
Moreover, even where the right medication arrives at the right patient for administration, and the correct medication in each infusion line is known, that medication may regardless be administered incorrectly in the case where the pump is programmed with incorrect infusion parameters. For example, even where the medication order includes the correct infusion parameters, those parameters may be incorrectly entered into al infusion pump causing the infusion pump to administer the medication in a manner that may not result in the prescribed treatment. The nurse may also start an infusion at the wrong time or forget to administer an infusion, resulting in incorrect treatment that may interfere with other scheduled medications prescribed by the physician. Such incorrect administration of the medication may occur even where the medication is to be administered using an automated or semi-automated administration device, such as an infusion pump, if the automated device is programmed with incorrect medication administration parameters. Even in an automated system where the medication has a bar code and that bar code includes infusion parameters, errors can occur. The bar code may have been improperly printed or may have been smudged so that it cannot be read accurately and in fact is read inaccurately. In other cases, the bar code may simply be incorrect. Because of such a risk, some health care facilities do not permit a bar code to be used for anything other than patient identification and medication identification. Such facilities prefer clinicians to manually program infusion pumps in that facility.
Even though the multi-channel and single-channel infusion pumps of today have provided significant advances in the art to avoid medication errors and have reduced the likelihood of such medication errors substantially, further improvements are possible and desired. Hence, those skilled in the art have recognized a need for an automatic identification system and method to associate the patient with the correct medication. Further, those skilled in the art have recognized a need for a more accurate system and method for programming operating or pumping parameters into infusion pumps so that errors are avoided. The present invention fulfills this need and others.